目的 分析宫颈癌术后患者营养风险与疾病感知的发展轨迹及两者之间的预测关系,为降低宫颈癌患者疾病感知、改善症状提供理论依据。方法 便利抽样选取2022年6月至2024年6月自贡市第四人民医院收治的132例宫颈癌患者作为研究对象,分别于T1(术后)、T2(术后1个月)以及T3(术后2个月)对其营养风险及疾病感知进行追踪调查。结果 本研究共回收有效问卷118份(回收率89.39%)。交叉滞后模型显示:初始水平下,营养风险与疾病感知间可以相互正向预测(β=0.423,P＜0.001),营养风险水平平均显著正向预测下一节点的疾病感知水平(T1→T2:β=0.440,P=0.012,T2→T3:β=0.430,P=0.004),疾病感知水平同样平均显著正向预测下一节点的营养风险水平(T1→T2:β=0.378,P=0.007,T2→T3:β=0.392,P=0.003)。潜变量增长模型显示,营养风险的初始水平能够正向预测疾病感知的初始水平(β=0.336,P=0.007),且能够正向预测疾病感知的发展速度(β=0.430,P=0.008)。营养风险的发展速度能够正向预测疾病感知的发展速度(β=0.469,P＜0.001)。结论 医护人员应重点监测宫颈癌术后患者2个月内营养状态与疾病感知变化,鼓励早期营养干预通过降低营养恶化速度间接缓解患者的症状疾病感知,从而改善患者预后、提高生存质量。
Abstract
Objective To analyze the developmental trajectory of nutritional risk and disease perception among postoperative patients with cervical cancer, and to explore the predictive relationship between these two factors, thereby providing a theoretical basis for reducing disease perception and alleviating symptoms in patients with cervical cancer. Method A total of 132 patients diagnosed with cervical cancer were selected as research subjects using convenient sampling. Their nutritional risk and disease perception were tracked and investigated at three distinct time points: T1 (immediately following surgery), T2 (one month post-surgery), and T3 (two months post-surgery). Result A total of 118 valid questionnaires were retrieved in this study, (yielding a recovery rate of 89.39%. The cross-lag model indicates that at the initial stage, nutritional risk and disease perception can positively predict each other (β=0.423, P < 0.001). Specifically, nutritional risk significantly and positively predicted illness perception at the subsequent time point (T1→T2: β=0.440, P=0.012; T2→T3: β=0.430, P=0.004). Similarly, the average disease perception level significantly and positively predicts the nutritional risk level at the next time point (T1→T2: β=0.378, P=0.007; T2→T3: β=0.392, P=0.003). The latent variable growth model reveals that the initial level of nutritional risk positively predicts the initial level of disease perception (β=0.336, P=0.007) and can also positively predict the rate of development of disease perception (β=0.430, P=0.008). Furthermore, the rate of development of nutritional risk can positively predict the rate of development of disease perception (β=0.469, P < 0.001).Conclusion Medical staff should concentrate on monitoring the nutritional status and changes in disease perception among patients within two months following cervical cancer surgery. Early nutritional intervention, including personalized dietary support and enteral nutrition supplementation, can not only mitigate the body's nutritional risk but also indirectly alleviate symptoms and disease perception by reducing the rate of nutritional decline. Consequently, this can improve patient prognosis and enhance their quality of life.
关键词
宫颈癌 /
术后 /
营养风险 /
疾病感知 /
轨迹 /
相关性 /
潜变量增长模型 /
交叉滞后模型
Key words
Cervical cancer /
Postoperative /
Nutritional risk /
Disease perception /
Trajectory /
Correlation /
Latent variable growth model /
Cross-lagged model
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024,74(3):229-263.
[2] Ji L, Chen M, Yao L. Strategies to eliminate cervical cancer in China[J]. Front Oncol, 2023,13:1105468.
[3] Wu S, Jiao J, Yue X, et al. Cervical cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with England and India based on the global burden of disease study 2019[J]. Front Public Health, 2024,12:1358433.
[4] Wu X, Sun Y, Yang H, et al. Cadonilimab plus platinum-based chemotherapy with or without bevacizumab as first-line treatment for persistent, recurrent, or metastatic cervical cancer (COMPASSION-16): a randomised, double-blind, placebo-controlled phase 3 trial in China[J]. Lancet, 2024,404(10463):1668-1676.
[5] Chen Y, Huang B, Zheng J, et al. Prediction study of prognostic nutrition index on the quality of life of patients with cervical cancer undergoing radiotherapy and chemotherapy[J]. PeerJ, 2023,11:e15442.
[6] Kim J Y, Lee D W, Kim M J, et al. Secondhand smoke exposure, diabetes, and high BMI are risk factors for uterine cervical cancer: a cross-sectional study from the Korea national health and nutrition examination survey (2010-2018)[J]. BMC Cancer, 2021,21(1):880.
[7] Lee S M, Seol A, Cho H W, et al. Optimal Dietary Intake of Riboflavin Associated with Lower Risk of Cervical Cancer in Korea: Korean National Health and Nutrition Examination Survey 2010-2021[J]. Life (Basel), 2024,14(4).
[8] Xu L, Tan Y, Xiang P, et al. Diet-Related Risk Factors for Cervical Cancer: Data from National Health and Nutrition Examination Survey 1999-2018[J]. Nutr Cancer, 2023,75(10):1892-1899.
[9] Lee S M, Shin D, Seol A, et al. Diabetes Is Positively Associated With High Risk of Depression in Korean Cervical Cancer Patients: Korean National Health and Nutrition Examination Survey 2010-2021[J]. Psychiatry Investig, 2025,22(1):57-65.
[10] Horovitz O. Nutritional Psychology: Review the Interplay Between Nutrition and Mental Health[J]. Nutr Rev, 2025,83(3):562-576.
[11] Riess C, Heimann Y, Schleussner E, et al. Disease Perception and Mental Health in Pregnancies with Gestational Diabetes-PsychDiab Pilot Study[J]. J Clin Med, 2023,12(10).
[12] Guo C, Zhan B, Li M Y, et al. Association between oral contraceptives and cervical cancer: A retrospective case-control study based on the National Health and Nutrition Examination Survey[J]. Front Pharmacol, 2024,15:1400667.
[13] Lee E A, Shin J, Hwang E J, et al. Breast and Cervical Cancer Screening Behavior in Female Cancer Survivors: The Korea National Health and Nutrition Examination Survey, 2007-2012[J]. Korean J Fam Med, 2017,38(3):116-121.
[14] 中国抗癌协会妇科肿瘤专业委员会. 子宫颈癌诊断与治疗指南(2021年版)[J]. 中国癌症杂志, 2021,31(6):474-489.
[15] 李贤, 刘桂芬, 何大卫, 等. 重复测量设计样本含量估计[J]. 中国卫生统计, 2001,18(4):204-206.
[16] Broadbent E, Petrie K J, Main J, et al. The brief illness perception questionnaire[J]. J Psychosom Res, 2006,60(6):631-637.
[17] 梅雅琪, 李惠萍, 杨娅娟, 等. 中文版疾病感知问卷简化版在女性乳腺癌患者中的信效度检验[J]. 护理学报, 2015(24):11-14.
[18] 汤丹丹, 温忠麟. 共同方法偏差检验:问题与建议[J]. 心理科学, 2020,43(01):215-223.
[19] Mishra A, Giuliani G, Longo V D. Nutrition and dietary restrictions in cancer prevention[J]. Biochim Biophys Acta Rev Cancer, 2024,1879(1):189063.
[20] Ahmedah H T, Basheer H A, Almazari I, et al. Introduction to Nutrition and Cancer[J]. Cancer Treat Res, 2024,191:1-32.
[21] Wiseman M J. Nutrition and cancer: prevention and survival[J]. Br J Nutr, 2019,122(5):481-487.
[22] Martinez-Garay C, Djouder N. Dietary interventions and precision nutrition in cancer therapy[J]. Trends Mol Med, 2023,29(7):489-511.
[23] Luo Y, Zhang L, Mao D, et al. Symptom clusters and impact on quality of life in lung cancer patients undergoing chemotherapy[J]. Qual Life Res, 2024,33(12):3363-3375.
[24] Koshimoto S, Yamazaki T, Amano K, et al. Psychosocial Factors and the Need for Multidisciplinary Support in Nutrition Counselling for Cancer Chemotherapy Patients[J]. Nutrients, 2023,15(12).
[25] Tripodi S I, Bergami E, Panigari A, et al. The role of nutrition in children with cancer[J]. Tumori, 2023,109(1):19-27.
[26] Barreira J V. The Role of Nutrition in Cancer Patients[J]. Nutr Cancer, 2021,73(11-12):2849-2850.
[27] Contaldo F, Santarpia L, Cioffi I, et al. Nutrition Transition and Cancer[J]. Nutrients, 2020,12(3).
[28] Zitvogel L, Pietrocola F, Kroemer G. Nutrition, inflammation and cancer[J]. Nat Immunol, 2017,18(8):843-850.
[29] Miao J, Wang L, Ong E, et al. Effects of induction chemotherapy on nutrition status in locally advanced nasopharyngeal carcinoma: a multicentre prospective study[J]. J Cachexia Sarcopenia Muscle, 2023,14(2):815-825.
[30] Anderson P M. Editorial of Special Issue "Diet and Nutrition during Chemotherapy and Radiotherapy"[J]. Nutrients, 2022,14(12).
[31] Puklin L S, Ferrucci L M, Harrigan M, et al. Improving lifestyle behaviors during chemotherapy for breast cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis (LEANer) Trial[J]. Cancer, 2024,130(14):2440-2452.
[32] Hamdan M H, Badrasawi M M, Abu A R. Nutrition and functional status among Palestinian cancer patients receiving chemotherapy[J]. J Taibah Univ Med Sci, 2022,17(2):264-270.
[33] Flores-Perez J A, de la Rosa O F, Argenes Y, et al. Nutrition, Cancer and Personalized Medicine[J]. Adv Exp Med Biol, 2019,1168:157-168.
[34] Puklin L S, Irwin M L, Sanft T, et al. Barriers to and facilitators of improving physical activity and nutrition behaviors during chemotherapy for breast cancer: a sequential mixed methods study[J]. Support Care Cancer, 2024,32(9):590.
[35] Momokita M, Abe A, Shibata K, et al. Association between oral function and nutrition in gastric cancer patients undergoing chemotherapy[J]. Oral Dis, 2023,29(8):3157-3163.
PDF(1195 KB)
